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Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Improvement of the quality payment program by improving data reporting process: an action research

Authors: Shabnam Iezadi, Jafar Sadegh Tabrizi, Akbar Ghiasi, Mostafa Farahbakhsh, Kamal Gholipour

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

Successful implementation of pay-for-quality (P4Q) programs mostly depends upon a valid, timely, and reliable data about quality measures generated by providers, and interpreted by payers. The aim of this study was to establish a data reporting method for P4Q program through an action research.

Methods

Qualitative method was used to align theory with action through a three-cycle action research. The study was conducted in September 15, 2015 to March 15, 2017, in East-Azerbaijan, Iran. The purposeful sampling was used to select participants. The participants included healthcare providers, staff in district health centers (DHC), experts, and managers in the provincial primary health center (PPHC). Data was collected by interviews, focus group discussions, and expert panels. Content analysis was used to synthesize the data. In each step, decisions about data reporting methods were made through a consensus of expert panel members.

Results

The most important dimensions of data reporting method were data entry and accuracy, data reporting, data analysis and interpretations, the flexibility of method, and training. By establishment of an online data reporting system for the P4Q program, a major improvement was observed in the documentation of performance data, the satisfaction of health care providers and staff (e.g. either in DHCs or PPHC), improvement of the P4Q program and acceptance of the P4Q program by providers. Following the present study, the online system was expanded in Iran’s public health system for data collection and estimating the amount of incentive payments in P4Q program. Moreover, more improvements were achieved by linking the system to EMRs and also, providing automated feedback to providers about their own performance.

Conclusions

A web-based computerized system with the capability of linking medical record and also its ability to provide feedback to healthcare providers was identified as an appropriate method of data reporting in the P4Q program from the viewpoints of participants in this study.
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Literature
2.
go back to reference Chung S, Palaniappan LP, Trujillo LM, Rubin HR, Luft HS. Effect of physician-specific pay-for-performance incentives in a large group practice. Am J Manag Care. 2010;16(2):e35–42. PubMed PMID: 20148608PubMed Chung S, Palaniappan LP, Trujillo LM, Rubin HR, Luft HS. Effect of physician-specific pay-for-performance incentives in a large group practice. Am J Manag Care. 2010;16(2):e35–42. PubMed PMID: 20148608PubMed
3.
go back to reference Doran T, Kontopantelis E, Valderas JM, Campbell S, Roland M, Salisbury C, et al. Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework. Br Med J. 2011;342. doi: https://doi.org/10.1136/bmj.d3590. PubMed PMID: WOS:000292458100002. Doran T, Kontopantelis E, Valderas JM, Campbell S, Roland M, Salisbury C, et al. Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework. Br Med J. 2011;342. doi: https://​doi.​org/​10.​1136/​bmj.​d3590. PubMed PMID: WOS:000292458100002.
4.
go back to reference Chen JY, Tian HJ, Juarez DT, Hodges KA, Brand JC, Chung RS, et al. The Effect of a PPO Pay-for-Performance Program on Patients With Diabetes. Am J Manag Care. 2010;16(1):E11–E9. PubMed PMID: WOS:000274077600010PubMed Chen JY, Tian HJ, Juarez DT, Hodges KA, Brand JC, Chung RS, et al. The Effect of a PPO Pay-for-Performance Program on Patients With Diabetes. Am J Manag Care. 2010;16(1):E11–E9. PubMed PMID: WOS:000274077600010PubMed
6.
go back to reference Anselmi L, Binyaruka P, Borghi J. Understanding causal pathways within health systems policy evaluation through mediation analysis: an application to payment for performance (P4P) in Tanzania. Implement Sci. 2017;12(1):10.CrossRefPubMedPubMedCentral Anselmi L, Binyaruka P, Borghi J. Understanding causal pathways within health systems policy evaluation through mediation analysis: an application to payment for performance (P4P) in Tanzania. Implement Sci. 2017;12(1):10.CrossRefPubMedPubMedCentral
9.
go back to reference Marshall L, Charlesworth A, Hurst J. The NHS payment system: evolving policy and emerging evidence. London: The Nuffield Trust; 2014. Marshall L, Charlesworth A, Hurst J. The NHS payment system: evolving policy and emerging evidence. London: The Nuffield Trust; 2014.
11.
go back to reference Greene SE, Nash DB. Pay for performance: an overview of the literature. Am J Med Qual. 2009;24(2):140–63.CrossRefPubMed Greene SE, Nash DB. Pay for performance: an overview of the literature. Am J Med Qual. 2009;24(2):140–63.CrossRefPubMed
12.
go back to reference Yegian J, Yanagihara D. Value based pay for performance in California. Integrated Healthcare Association. 2013;9:1–5. Yegian J, Yanagihara D. Value based pay for performance in California. Integrated Healthcare Association. 2013;9:1–5.
13.
go back to reference Cashin C, Chi Y-L, Smith P. Paying for performance in health care. 2015. Cashin C, Chi Y-L, Smith P. Paying for performance in health care. 2015.
14.
go back to reference Tabrizi JS, Gholipour K, Iezadi S, Farahbakhsh M, Ghiasi S. A framework to assess management performance in district health system: a qualitive and quantitive case study in Iran. Cad Saude Publica. 2018;34(3):e00071717.PubMed Tabrizi JS, Gholipour K, Iezadi S, Farahbakhsh M, Ghiasi S. A framework to assess management performance in district health system: a qualitive and quantitive case study in Iran. Cad Saude Publica. 2018;34(3):e00071717.PubMed
15.
go back to reference Sharifi M, Ayat M, Jahanbakhsh M, Tavakoli N, Mokhtari H, Wan Ismail WK. E-health implementation challenges in Iranian medical centers: a qualitative study in Iran. Telemedicine and e-Health. 2013;19(2):122–8.CrossRefPubMed Sharifi M, Ayat M, Jahanbakhsh M, Tavakoli N, Mokhtari H, Wan Ismail WK. E-health implementation challenges in Iranian medical centers: a qualitative study in Iran. Telemedicine and e-Health. 2013;19(2):122–8.CrossRefPubMed
18.
19.
go back to reference Eijkenaar F. Key issues in the design of pay for performance programs. Eur J Health Econ. 2013;14:117–31.CrossRefPubMed Eijkenaar F. Key issues in the design of pay for performance programs. Eur J Health Econ. 2013;14:117–31.CrossRefPubMed
22.
go back to reference Morse JM. Critical analysis of strategies for determining rigor in qualitative inquiry. Qual Health Res. 2015;25(9):1212–22.CrossRefPubMed Morse JM. Critical analysis of strategies for determining rigor in qualitative inquiry. Qual Health Res. 2015;25(9):1212–22.CrossRefPubMed
23.
go back to reference Bardach NSMDMAS, Wang JJP, De Leon SFP, Shih SCMPH, Boscardin WJP, Goldman LEMDMCR, et al. Effect of Pay-for-Performance Incentives on Quality of Care in Small Practices With Electronic Health Records: A Randomized Trial. JAMA. 2013;310(10):1051–9. PubMed PMID: 1437231099; 24026600CrossRefPubMedPubMedCentral Bardach NSMDMAS, Wang JJP, De Leon SFP, Shih SCMPH, Boscardin WJP, Goldman LEMDMCR, et al. Effect of Pay-for-Performance Incentives on Quality of Care in Small Practices With Electronic Health Records: A Randomized Trial. JAMA. 2013;310(10):1051–9. PubMed PMID: 1437231099; 24026600CrossRefPubMedPubMedCentral
24.
go back to reference Robinson JC, Casalino LP, Gillies RR, Rittenhouse DR, Shortell SS, Fernandes-Taylor S. Financial incentives, quality improvement programs, and the adoption of clinical information technology. Med Care. 2009;47(4):411–7.CrossRefPubMed Robinson JC, Casalino LP, Gillies RR, Rittenhouse DR, Shortell SS, Fernandes-Taylor S. Financial incentives, quality improvement programs, and the adoption of clinical information technology. Med Care. 2009;47(4):411–7.CrossRefPubMed
28.
go back to reference Kruse G, Chang Y, Kelley JHK, Linder JA, Einbinder J, Rigotti NA. Healthcare System Effects of Pay-for-performance for Smoking Status Documentation. Am J Manag Care. 2013;19(7):554–61. PubMed PMID: PMC3874815PubMedPubMedCentral Kruse G, Chang Y, Kelley JHK, Linder JA, Einbinder J, Rigotti NA. Healthcare System Effects of Pay-for-performance for Smoking Status Documentation. Am J Manag Care. 2013;19(7):554–61. PubMed PMID: PMC3874815PubMedPubMedCentral
29.
go back to reference Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144(10):742–52.CrossRefPubMed Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144(10):742–52.CrossRefPubMed
31.
go back to reference Hong CS, Atlas SJ, Chang Y, Subramanian S, Ashburner JM, Barry MJ, et al. Relationship between patient panel characteristics and primary care physician clinical performance rankings. JAMA. 2010;304(10):1107–13.CrossRefPubMed Hong CS, Atlas SJ, Chang Y, Subramanian S, Ashburner JM, Barry MJ, et al. Relationship between patient panel characteristics and primary care physician clinical performance rankings. JAMA. 2010;304(10):1107–13.CrossRefPubMed
32.
go back to reference Mehrotra A, Pearson SD, Coltin KL, Kleinman KP, Singer JA, Rabson B, et al. The response of physician groups to P4P incentives. Am J Manag Care. 2007;13(5):249.PubMed Mehrotra A, Pearson SD, Coltin KL, Kleinman KP, Singer JA, Rabson B, et al. The response of physician groups to P4P incentives. Am J Manag Care. 2007;13(5):249.PubMed
33.
go back to reference Huntington D, Zaky HH, Shawky S, Fattah FA, El-Hadary E. Impact of a service provider incentive payment scheme on quality of reproductive and child-health services in Egypt. J Health Popul Nutr. 2010;28(3):273–80. PubMed PMID: 20635638; PubMed Central PMCID: PMCPMC2980892CrossRefPubMedPubMedCentral Huntington D, Zaky HH, Shawky S, Fattah FA, El-Hadary E. Impact of a service provider incentive payment scheme on quality of reproductive and child-health services in Egypt. J Health Popul Nutr. 2010;28(3):273–80. PubMed PMID: 20635638; PubMed Central PMCID: PMCPMC2980892CrossRefPubMedPubMedCentral
34.
Metadata
Title
Improvement of the quality payment program by improving data reporting process: an action research
Authors
Shabnam Iezadi
Jafar Sadegh Tabrizi
Akbar Ghiasi
Mostafa Farahbakhsh
Kamal Gholipour
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3472-4

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